Winnipeg ER doctors want immediate changes to protect patient care after weekend crisis
Health Minister Audrey Gordon said she will meet with hospital leaders, nurses at Health Sciences Centre
Two Winnipeg emergency doctors are calling for immediate changes after the province's largest emergency ward ran out of room over the weekend.
On Tuesday, CBC reported that a dozen severely ill patients were lined up on stretchers in an entrance hallway at Winnipeg's Health Sciences Centre Sunday night because of a lack of space inside.
HSC emergency department physician Dr. Merril Pauls says ERs in the province need to be scaled up, as intensive care beds were during previous waves of the COVID-19 pandemic.
"That's a model we've used within the last couple of years that really shows that we can do something different right now," he said in a Wednesday interview with CBC Manitoba's Information Radio.
"We don't have to wait years from now. We don't have to wait till a new crop of people are trained up."
He also wants to see hospitals create overcapacity protocols that would see more patients admitted into staffed medicine wards, rather than leaving the emergency department overwhelmed with critically ill patients like HSC's was on the weekend.
Protocols currently in place say ambulances must offload patients into the emergency room after a certain amount of time, and then head back into service to pick up more patients.
That policy is intended to minimize the risk associated with long wait times, but Pauls says it effectively shifts that risk to the strained emergency departments.
"We come to a critical place where there just is no more risk that can be accepted by the patients in our department or the nurses taking care of them," he said.
In addition, some family doctors from across the province send patients to emergency rooms because there's no other way to access certain tests or specialist care, which could be offered elsewhere, he said.
"Those are all ways that tomorrow we could change our policies to take some of that pressure off [the emergency department]."
Solution not so simple: HSC head
Michael Howlett, the president of the Canadian Association of Emergency Physicians, says overwhelmed emergency rooms are a problem across the country and are a product of an aging population, underfunded health care, a shortage of staff and insufficient efforts to plan for the future.
"It is indeed the worst that I have seen it since I started working in 1987, bar none. This is definitely most consistently the worst that I've ever seen," he said in a Wednesday interview.
Howlett says emergency departments deal with too much.
"It's a complex problem, but it comes down to human resources. Do we have the people in the system to support the level of health care that people want or need?" he said.
"It's a public-equity question. What is it that our society wants for its level of care, and what are they willing to invest?"
The head of Health Sciences Centre says staffing challenges are one reason it's not so simple to scale up its emergency department.
"At the very beginning of the pandemic we had a lot more staff … and all the attention was in one or two main areas, so we were able to collapse certain areas of the health-care system that were less acute," chief operating officer Shawn Young said in a Tuesday interview.
"That ability is now gone. There is no pool of staff we can draw from to be able to support the needs in the emergency departments right now."
While hospitals in the province wait for new nurses to be trained and recruited, Young says hospital staff are being shifted every day to whichever department needs them most.
"We have to make sure that we're there for the most acutely in-need patients, but it does mean other patients are going to wait, unfortunately."
As of mid-afternoon Wednesday, wait times at HSC's emergency department were just over eight hours, according to the Winnipeg Regional Health Authority website. The wait was even worse at the St. Boniface ER (9.25 hours) and only slightly better at Grace (7.75 hours).
Asked Wednesday about the completely full emergency room at HSC on the weekend, Manitoba Health Minister Audrey Gordon thanked health-care workers for their work, but chalked the number of patients up to a weekend fluctuation.
"We tend to see over our weekends and our long weekends, particularly in the summer, fluctuations and increases in the level of acuity of care," she said at an unrelated news conference.
She walked back the comment later in the conference, saying she didn't want to minimize concerns, and said she will meet with HSC's leadership team and front-line nurses to see what solutions can be put into action.
Nurses 'left in the lurch': doctor
Another Winnipeg emergency physician, who is on staff at St. Boniface Hospital, says those in power need to show with their actions how important their "health care heroes" are.
"Stop trying to pay lip service and actually prove that you value health-care workers, particularly nursing staff, who have been nothing but left in the lurch in a really concerningly depressing manner," said the doctor, who spoke with CBC on Tuesday on condition of anonymity.
"I think there's a lack of understanding of the importance that they play and how much of a linchpin of our system are."
He wonders why politicians aren't heeding the advice of health-care workers, "despite us screaming it over and over and over again as people living the situation," the doctor said.
Manitoba's Opposition party echoed those concerns at a Wednesday news conference.
"We need to have the government admit that there's a crisis in our health-care system," NDP Leader Wab Kinew said. "The reality is this: we need a long-term plan to fix health care in Manitoba."
Kinew accused the Progressive Conservative government of downplaying their role in the current health-care situation.
"We've all watched the cuts to health care, the closures of the ERs, the cuts to CancerCare, the cuts to nursing positions. We know the genesis of the problem lies at the political level."
Gordon says the province has spent millions to ensure doctors are in triage and creating nurse education seats.
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With files from Bartley Kives, Ian Froese and Cory Funk